2167.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
I B uilding Permit Application
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MS- 2014 -02167 °wise of a� www.blairnebraska.org
08/1412014 MISC Residential August 14, 2014
A LOCATION OF IMPROVEMENT: 777 N 16th St, Blair, NE 68008
r w ARCHITECT: GENERAL Thompson & Thompson 3rd Generation
OWNER: CONTRACTOR:
Dennis And Vickie Brummer _
709 Avenue A
777 N 16th St Plattsmouth, NE 68048
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08113/2016
777N16thSt- 140814 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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1. No work will be started before a permit is ISSUED AND POSTED.
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is issued.
5. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or "out the intention of the undersigned or any alteration or change from this application without approval of the
Build' g cial, shall constitute round for the revocation of any permit issued which was based on the approval of this
W plic0ron. _
a re 6 Wrcant
Date